Provider Demographics
NPI:1144852039
Name:HOME GROWN OCCUPATIONAL & PHYSICAL THERAPY 4 KIDS, PC
Entity type:Organization
Organization Name:HOME GROWN OCCUPATIONAL & PHYSICAL THERAPY 4 KIDS, PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/PRESIDENT
Authorized Official - Prefix:MRS
Authorized Official - First Name:DEBORAH
Authorized Official - Middle Name:LYNN
Authorized Official - Last Name:KEMPSTON
Authorized Official - Suffix:
Authorized Official - Credentials:OTR/L
Authorized Official - Phone:858-254-1243
Mailing Address - Street 1:30033 TECHNOLOGY DR STE 104
Mailing Address - Street 2:
Mailing Address - City:MURRIETA
Mailing Address - State:CA
Mailing Address - Zip Code:92563-2640
Mailing Address - Country:US
Mailing Address - Phone:951-813-2820
Mailing Address - Fax:951-461-0535
Practice Address - Street 1:30033 TECHNOLOGY DR STE 104
Practice Address - Street 2:
Practice Address - City:MURRIETA
Practice Address - State:CA
Practice Address - Zip Code:92563-2640
Practice Address - Country:US
Practice Address - Phone:951-813-2820
Practice Address - Fax:951-461-0535
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-02-07
Last Update Date:2021-03-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225XP0200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistPediatricsGroup - Multi-Specialty
No2251P0200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistPediatricsGroup - Multi-Specialty
No235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language PathologistGroup - Multi-Specialty